Musculoskeletal Research Projects

Musculoskeletal Research Program

Effects of laterally-wedged insoles on symptoms and disease progression in knee osteoarthritis

Role of musculoskeletal biomechanical factors in cartilage loss in those who undergo arthroscopic partial medial menisectomy

Efficacy and cost effectiveness of physiotherapy management for chronic rotator cuff pathology

Impairments in individuals with and without chronic rotator cuff pathology

Effect of experimentally induced knee pain on knee neuromotor control

Effect of quadriceps muscle fatigue on onset timing of the quadriceps

Is motor control of the hip disrupted in individuals with patellofemoral pain syndrome?

Evaluation of an osteoporosis prevention and self management program.

Improving exercise prescription for postmenopausal women at risk of osteoporosis.

Efficacy of a physiotherapy intervention programme for individuals with a history of osteoporotic vertebral fracture: A randomised controlled pilot study

Falls prevention and risk assessment in the acute hospital

Effects of laterally-wedged insoles on symptoms and disease progression in knee osteoarthritis

Investigators 

Prof Kim Bennell, Dr Rana Hinman, Mr Tim Wrigley, A/Prof Flavia Cicuttini, Mr Craig Payne, A/Prof Anthony Harris

Summary
As there is presently no cure for knee osteoarthritis, strategies that slow progression of the disease will reduce the personal and societal burden of arthritis. Most research has focussed on drug therapies, which are effective in reducing pain and disability but have side effects and are expensive. Insoles worn inside the shoes are a simple, cheap, self-administered intervention with the potential to slow disease progression in certain patients, in addition to managing symptoms. This randomised, double-blind, placebo controlled trial aims to see whether 12 months of wearing insoles can lead to improvements in knee pain and function and slow disease progression in 200 people with knee osteoarthritis.   It will use state-of-the-art technology, magnetic resonance imaging, to measure changes in the amount of knee cartilage. A second aim of the project is to evaluate the cost-effectiveness of this intervention.

Funding Source
NHMRC Project Grant #350297 2005-2008, ANZ Charitable Trusts

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Role of musculoskeletal biomechanical factors in cartilage loss in those who undergo arthroscopic partial medial menisectomy

Investigators 

Prof Flavia Cicuttini, Dr David Lloyd, Prof Kim Bennell, Mr Tim Wrigley, Prof Gwidon Stachowiak, A/Prof Andrew Forbes

Summary
People who undergo an arthroscopic partial medial menisectomy lose more knee joint cartilage in the years following surgery and are more likely to develop osteoarthritis in the longer-term. This multisite project being conducted in Melbourne and Perth will follow 180 people who have undergone this procedure over 2 years to see whether certain musculoskeletal and biomechanical factors can predict who loses more cartilage. MRI scans will be taken at baseline (3 months after surgery) and again at 2 years to measure changes in knee cartilage.   Laboratory measurements of walking patterns, muscle strength and lower limb alignment will be taken. If we can identify factors that predict loss of cartilage, it may be possible to design rehabilitation strategies to address these factors and reduce the risk of knee osteoarthritis in this patient population.

Funding Source
NHMRC Project Grant #334151 2005-2008

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Efficacy and cost effectiveness of physiotherapy management for chronic rotator cuff pathology

Investigators
Prof Kim Bennell, Vince Anderson, Sally Coburn, Dr Andrea Bialocerkowski, Prof Rachelle Buchbinder, A/Prof Sally Green, A/Prof Anthony Harris, A/Prof Andrew Forbes

Summary
Shoulder disorders are a common cause of musculoskeletal morbidity affecting 15-30% of adults at any one time. A large proportion of shoulder problems can be classified under the term 'chronic rotator cuff pathology' (CRCP) which involves the contractile structures around the shoulder joint. Physiotherapy is often used to manage this condition.This randomised, double-blind, placebo controlled trial is being conducted in association with the Physiotherapy Department at the Royal Melbourne Hospital. It aims to investigate whether a 10-week (10-visit) multimodality physiotherapy program is efficacious in reducing pain and disability and improving health-related quality-of-life in individuals with CRCP and whether effects can be maintained at 3 months. A secondary aim is to investigate the cost-effectiveness of such an intervention

Funding Source
NHMRC project grant 2004-2006
Physiotherapy Department Royal Melbourne Hospital

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Impairments in individuals with and without chronic rotator cuff pathology

Investigators
Vince Anderson, Prof Kim Bennell, Dr Andrea Bialocerkowski, Prof Paul Hodges

Summary
Chronic Rotator Cuff Pathology (CRCP) is a common condition that results in pain, as well as functional limitations in strength and mobility of the upper limb.  This project aims to compare strength, proprioception, thoracic spine range of movement, muscle activation patterns and scapulo-thoracic posture in individuals with and without CRCP.  It will also compare impairments between unaffected and affected sides in the CRCP population as well as identify inter-relationships between the impairments. This will help to direct physiotherapy management as well as provide insight into possible factors contributing to the initiation and perpetuation of the condition.

Funding Source
NHMRC Project Grant 2004-2006

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Effect of experimentally induced knee pain on knee neuromotor control

Investigators 

Prof Kim Bennell, Prof Paul Hodges, Dr Michael Coppieters, Dr Rebecca Mellor

Summary
Patellofemoral pain syndrome (PFPS) is a common condition in the sporting and general populations. Our research group has found that people with PFPS have delayed onset of vastus medialis oblique (VMO) compared to vastus lateralis (VL). This change in motor control of the vasti may precede the onset of pain or may occur as a result of pain. This study investigated whether experimentally induced knee pain (via injection of hypertonic saline into the knee fat pad) could influence motor control in 10 healthy individuals as they performed stair stepping and walking tasks.

Funding Source
NHMRC Project Grant 2002-2004

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Effect of quadriceps muscle fatigue on onset timing of the quadriceps

Investigators 

Prof Kim Bennell, Prof Paul Hodges, Dr Michael Coppieters Dr Debra Falla, Rebecca Mellor

Summary
Fatigue of muscles is associated with changes in proprioception, motorneuron excitability and motor cortical drive amongst other effects. A change in any of these parameters could alter the co-ordination of muscle contraction. This experiment examines whether fatigue of the quadriceps muscles alters the timing of onset of the vastus lateralis and vastus medialis oblique portions of the quadriceps. The quadriceps muscles of healthy individuals with no history of knee pain were fatigued via repeated submaximal isometric knee extension. Muscle onset was measured using surface electromyography during stair stepping and walking in the presence and absence of quadriceps muscle fatigue

Funding Source
NHMRC Project Grant 2002-2004

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Is motor control of the hip disrupted in individuals with patellofemoral pain syndrome?

Investigators 

Dr Sallie Cowan, Prof Kim Bennell

Summary
This project builds on our previous work investigating patellofemoral pain (PFP) and aims to investigate possible links between changes in vasti recruitment and motor control at the hip in the presence of PFP. Specifically the research program aims to assess the relationship between the control of the gluteal muscles and the vasti and seeks to investigate correlations of these measures with measures of knee and hip control.

Funding Source
NHMRC Project Grant 2002-2004

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Evaluation of an osteoporosis prevention and self management program

Investigators
Kate Francis, Dr Bernadette Matthews, Prof Kim Bennell, Dr Richard Osborne, Prof Willem van Mechelen

Summary
Osteoporosis is a major and growing public health problem. Self-management courses for people with chronic conditions such as osteoporosis have been recommended on the premise that they help patients better manage their condition and contribute to preventive behaviour, ultimately improving health and reducing healthcare costs. However, there has been no comprehensive evaluation of the efficacy of osteoporosis specific programs, particularly in the Australian setting. This randomised controlled trial aims to determine the effectiveness of an established 4-week community-based prevention and self-management program for individuals who have or are at risk of osteoporosis. Questionnaires will be utilised to assess changes in osteoporosis knowledge, skill and technique transfer, and attitudes towards maximising bone health and minimising symptoms in 260 older individuals. This research will provide comprehensive information on the program's impact on participants, as well as the quality of education supplied.

Funding Source
Early Career Researcher Grant, The University of Melbourne

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'Bones For Life'

Improving exercise prescription for postmenopausal women at risk of osteoporosis.

Investigators
Prof Kim Bennell, Dr Bernadette Matthews, Karen Bolton, Elin Wee, Prof John Wark

Summary
Osteoporotic related hip fractures are common in Australia and have serious implications for mortality, morbidity and cost. This randomized controlled trial will evaluate whether a 12 month exercise program together with adequate calcium intake, is effective in reducing bone loss and improving falls risk factors in postmenopausal women at risk of sustaining an osteoporotic fracture. Postmenopausal women with low bone density will be randomised to either an exercise or control group and measured before and after the intervention. The results of this study have implications for directing exercise guidelines and promoting the important role of safe physical activity in this population.

FundingSource
Swisse Vitamins Pty Ltd, YMCA Victoria

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Efficacy of a physiotherapy intervention programme for individuals with a history of osteoporotic vertebral fracture: A randomised controlled pilot study

Investigators
Prof Kim Bennell, Dr Bernadette Matthews, Judy Larsen, Margaret Sherburn, Alison Greig, Prof John Wark

Summary
Vertebral fractures are common in the osteoporotic population, and these spinal fractures can lead to pain, abnormal posture, reduced function and reduced quality of life. This pilot study will investigate the effectiveness of a physiotherapy treatment program which aims to increase back extensor muscle strength and endurance, decrease thoracic kyphosis, improve static and dynamic balance, and improve function and quality of life in individuals with osteoporosis. Results of this study will develop further understanding of the appropriate treatment options for individuals with osteoporotic vertebral fractures and provide the impetus for the progression into a larger clinical trial

Funding Source
ANZ Charitable Trusts

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Falls prevention and risk assessment in the acute hospital

Investigators
Willeke Walsh, Prof Kim Bennell, Dr Keith Hill

Summary
Falls are a serious health issue which affect the faller, their families/carers and health care providers. With an increasing elderly population the physical, psychological and economic cost of falls has the potential to rise considerably. Falls can occur in hospitals and limited research has been conducted in this area, especially in the acute setting. Falls prevention is ideal and best addressed in a multifactorial manner. This project involves the design of a falls assessment tool appropriate to the acute setting. The tool will identify particular patient specific risk factors, as well as provide a framework from which appropriate strategies to decrease the potential outcomes of falls can be determined. Testing of predictive validity and inter- and intra- rater reliability will be completed on a typical acute hospital population

Funding Source
Victorian Department of Human Services Aged Care Division

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